In a recent seven-to-two opinion in the case of Little Sisters of the Poor Saints Peter and Paul Home v. Pennsylvania, et al., the U.S. Supreme Court upheld the rights of certain employers to claim exemption from providing contraceptive care under the preventive care mandate of the Affordable Care Act (?Ç£ACA?Ç¥) based on religious or moral objections. General Background of the Case The ACA requires covered employers to provide women with ?Ç£preventive care and screenings?Ç¥ without any cost sharing requirements (the ?Ç£Preventive Care Mandate?Ç¥). The ACA relies on ?Ç£preventive care guidelines?Ç¥ (?Ç£Guidelines?Ç¥) supported by the Health Resources and Services Administration (?Ç£HRSA?Ç¥), an agency of the federal Department of Health and Human Services, to determine what ?Ç£preventive care and screenings?Ç¥ should include. The Guidelines mandate that health plans provide coverage for all FDA approved contraceptive methods. When the Departments of Health and Human Services, Labor, and the Treasury (collectively, the ?Ç£Departments?Ç¥)… Continue Reading
In December 2017, two federal district courts granted nationwide preliminary injunctions from enforcement of the interim final rules providing for religious and moral exemptions from the contraceptive coverage mandate under the ACA issued in October 2017 by the U.S. Departments of Health and Human Services, Labor, and the Treasury (collectively, the ?Ç£Departments?Ç¥). Please see our earlier discussion of these exemptions. Both federal courts held that the Departments impermissibly bypassed the notice and comment rulemaking requirements of the Administrative Procedures Act and that the plaintiffs, consisting of six states, sufficiently demonstrated they would be harmed without an injunction. The timing of these injunctions is a cause for concern for any plan sponsors who have already acted in reliance on the interim final rules. The U.S. Department of Justice has indicated it disagrees with these rulings and may appeal. View Commonwealth of Pennsylvania v. Trump. View State of California v. Health and… Continue Reading
The U.S. Departments of the Treasury, Labor, and Health and Human Services have issued new interim final rules to expand the exemptions from the contraceptive coverage mandate under the Affordable Care Act. The new exemptions encompass (i) non-governmental plan sponsors and institutions of higher learning that object to the mandate based on sincerely held religious beliefs, and (ii) certain entities and individuals that object to the mandate based on sincerely held non-religious moral convictions. The interim final rules keep the accommodation process as an optional process for certain exempt entities that wish to use it voluntarily. Exempt entities must ensure that the exclusion of contraceptive coverage is clear in the plan document. The interim final rules were effective October 6, 2017. The interim final rules are available?áhere and?áhere.
The U.S. Equal Employment Opportunity Commission (?Ç£EEOC?Ç¥) recently issued ?Ç£Enforcement Guidance: Pregnancy Discrimination and Related Issues?Ç¥ (the ?Ç£Guidance?Ç¥) which addresses and clarifies various requirements of the Pregnancy Discrimination Act.?á By way of background, the Pregnancy Discrimination Act was passed in 1978 and amended Title VII of the Civil Rights Act of 1964 (?Ç£Title VII?Ç¥) to confirm that discrimination based on pregnancy, childbirth, or related medical conditions is a form of sex discrimination prohibited by Title VII.?á As applicable to employer-sponsored health plans, the Guidance states that, because prescription contraceptives are available only for women, an employer could violate Title VII by failing to provide coverage of prescription contraceptives (whether for birth control or medical purposes) where it provides coverage for prescription drugs, devices, and services that are used to prevent the occurrence of medical conditions other than pregnancy (the ?Ç£Title VII Contraceptive Mandate?Ç¥).?á The Guidance caveats in a footnote that… Continue Reading
The U.S. Supreme Court?ÇÖs decision in Burwell v. Hobby Lobby Stores, Inc. was announced on June 30.?á The Court held that the regulations issued by the U.S. Department of Health and Human Services (?Ç£HHS?Ç¥) under the Affordable Care Act (the ?Ç£Act?Ç¥), which require the group health plans of applicable large employers (generally 50 or more full-time employees) to provide their female employees with no-cost access to contraceptives, violated the federal Religious Freedom Restoration Act (?Ç£RFRA?Ç¥) as applied to the plans of closely-held for-profit corporations with sincerely held religious beliefs relating to contraceptives. Background As part of the Act?ÇÖs requirement that group health plans of applicable large employers must provide ?Ç£preventive care and screenings?Ç¥ for women without ?Ç£any cost sharing requirements,?Ç¥ HHS issued regulations requiring full coverage of the 20 contraceptive methods approved by the U.S. Food and Drug Administration.?á The plaintiffs in Hobby Lobby objected to four of the required… Continue Reading